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Utah in the Weeds Episode #41 – What You Can Expect with Utah Medical Cannabis in 2021

What to Expect in this Episode

It's always interesting when Chris and Tim have an opportunity to sit down with someone heavily involved with the policy side of Medical Cannabis in Utah. That's just what happened in episode 41 of Utah in the Weeds. Our hosts had a fascinating conversation with the Utah Department of Health's (UDOH) Katie Barber. Barber's official title is Health Program Specialist. Her job involves everything from maintaining EVS software to sitting in on Compassionate Use Board meetings. Tim & Chris discuss all of this with her and more.

In this episode, there is quite a bit of discussion about the transition from letters to Medical Cannabis cards.[09:12] As of January 1, letters are no longer acceptable in Utah. Medical Marijuana users must have state-issued cards. Barber discussed why the transition was made. [10:11] She explained that Medical Cannabis cards just make it easier for the UDOH to track what's going on for regulatory purposes.

Tim and Chris also discussed the Compassionate Use Board in-depth with Katie. [17:34] She explained that the Board rarely denies applicants. When they do, it is typically for lack of information or concerns over continuity of care. Barber said that the Board tweaks its policies with every meeting, in hopes of improving them.[18:17]

In the later part of the discussion, Katie talks about how UDOH seeks to educate both patients and doctors. [31:48] They want patients to understand how easy it is to get a Medical Marijuana Card. They want providers to know how they can go about becoming QMPs. It was a fantastic dialogue answering some of the most frequently asked questions Tim and Chris receive.

This episode is for anyone who wants to know what they are thinking over at the UDOH. You won’t want to miss it.

Resources in This Episode

Podcast Transcript

Chris Holifield: This is episode 41, of Utah in the Weeds. And my name is Chris Holifield ...

Tim Pickett: And I'm Tim Pickett. I mean, I kind of wanted to just jump in because I'm so excited about our guest today. This is the podcast for cannabis culture in Utah, really. And cannabis culture is a medical ... It's really a medical culture because of the Utah Medical Cannabis Program. And today we have really, who I consider the workhorse of the whole program, Katie Barber. She works for the Department of Health, and what's your official title, Katie?

Katie Barber: My official title is Health Program Specialist.

Tim Pickett: But I run the whole program.

Katie Barber: But I do a lot of things at the program, yeah.

Tim Pickett: Right, right.

Katie Barber: Team effort.

Tim Pickett: Okay. Yeah, I'm excited about this, Chris.

Chris Holifield: Where do you want to start with her? Because I mean, I was looking here over everything she's got going on there. I mean, there is so much that we could talk about.

Tim Pickett: I'm interested in maybe finding out how you came to be with the Department of Health in the program.

Katie Barber: Yeah, that is a great question. I joined the program in October of 2019, and I joined them after spending three years in retail pharmacy, and additionally working in harm reduction. So, this type of alternative treatment, helping Utah's public in a non-traditional way sort of, was really of interest to me. My other background, my educational background, is health policy and communication, and health and science communication. So, this job was perfect. The program was just starting out, it was in a field that I wanted to be in, especially in a beginning field in Utah, like it is. And it was an opportunity not to just interface with Utah's public, but to help Utah's public in this new way. So, that's how long I've been there, that's why I got involved, and it's been a wild ride.

Chris Holifield: Now, are you a Medical Cannabis user yourself? Or what's your relationship with cannabis?

Katie Barber: I am not a patient. But I have family members who have benefited from it. So, and-

Chris Holifield: Very cool.

Katie Barber: ... every day I hear amazing stories from our patients. So, it's not out-of-the-realm possibility for me, that's for sure.

Chris Holifield: So, you are open to it.

Katie Barber: Oh yeah, absolutely. And even though there's a lot of research that needs to be done on it, just the anecdotal evidence to me is really compelling for something as simple as a backache, to debilitating arthritis. My family members have benefited from it because they have arthritis, so it's ... I watch people flourish before my eyes just as part of being in this program, and then from hearing how it benefits people. So, it's hard to deny that there's something to it, even though it's not FDA regulated. It's hard to deny that there's not something to this.

Tim Pickett: Yeah, for sure. I mean, did you have a pretty good knowledge of cannabis before you started with the Department of Health?

Katie Barber: No, I really didn't have any knowledge of cannabis. That really all started when I joined in 2019, learning about it. And it's been really fascinating. I've approached it more from a policy perspective, I've been fortunate enough to be part of our compassionate use board, and help out with our cannabinoid product board. So, I get to learn the research that's going on around the country, and around the world. So, yeah. I didn't know anything about it until I joined, really.

Tim Pickett: Did you grow up here, in Utah?

Katie Barber: Yeah. I'm born and raised in Utah. Went to the U, and stayed here.

Tim Pickett: That's pretty cool. I mean, I am too, and we're ... I think this perspective of it's those rich, and so many people that are involved in the program are really just homegrown. So, there are people in Utah who are open-minded, apparently, who were born here and raised here.

Katie Barber: Yeah. Our projections were much lower by the end of the year than we hit, so we far exceeded expectations for patient ... For cardholders. And the interest has been way higher than we anticipated, even for providers. Just people who want to find out more, maybe they want to seek treatment for their family member, they're looking into how much research is out there, what the Department of Health can provide, which is a lot. We have a lot of resources. And I think it's caught on, especially because there was this initial interest. More and more people are talking about how it's benefiting them, so we kind of just see this domino effect. I think the people who hear, "Hey, this worked for me, might work for you." And it's surprising, because we are such a ... Utah has certain cultural factors that prevent us from thinking about something that's not regulated, typically. We are much more of a by-the-books type of people, I'd say.

Katie Barber: So, it has been awesome to see the growth, and see people benefit from it.

Tim Pickett: In your communications, you're always been pretty positive about the fact that the program is doing better, or growing bigger than you anticipated. So, what was the original projection? Something like 16,000 in the beginning?

Katie Barber: I don't even think it was that much. I think it was closer towards 10,000, 8,000 cards by the end of the year. It wasn't that many.

Chris Holifield: I thought I heard even 6,000.

Katie Barber: Yeah, I think we've almost about doubled that growth over our projections.

Tim Pickett: Yeah, you're at over 30,000 legal users now?

Katie Barber: I can give you the updated number. We are between 18,000 and 18,500.

Tim Pickett: Of legal card holding ... Okay. So, this is good news, because there isn't anybody in the state who probably knows this number better than you.

Katie Barber: Oh yeah. Oh, yes. So, we've got a small team. So, actually one of our teammates is pretty much approving all of these. It's a small team, so she is the one that really has seen all of these cards come through her desk. I help patients along the way, and ... But she really has been pushing through on these approvals, and we had such a wave leading up to the end of the year because of the law change. And so, we saw about 2,000 more just between November and December kick up.

Tim Pickett: Wow. Okay, so just so everybody knows, I'm going to back up and I'm going to basically reintroduce you. You are part of a small team at the Utah Department of Health, who specializes in cannabis. And really the policy surrounding how to get a card, what the process is like through that EVS system, the electronic verification system. And you're really an expert in that system.

Katie Barber: Right, yeah. And just to add to that, we facilitate the law, so we can suggest things about policy. And of course, we have the Utah Department of Health rule, but we are facilitating what the statute tells us to. So, yes, that includes an electronic system that was mandated by the legislature, everything had to be electronic for people to get cards. And that's what we do, day in, day out. That's what our help desk is for, is helping people get their cards. And occasionally telling people how the law works. People ask questions about that, too.

Tim Pickett: Flash back to March 1st, 2020, the day it all opened. We had card number one, right on the podcast, David Sutherland. He's a friend of ours, and what was that like when this all opened up for you and your team?

Katie Barber: It's crazy. We've grown since then so our team was even smaller at that time. But to watch everything, it really did come together on March 1st and March 2nd, when the first pharmacy opened. And it's the culmination of everything, because there had been so much work done to create the software, make sure we were adhering to the statute. You trying to anticipate things that will make it easy for patients to get cards, and then next thing you know you're in there on a Saturday at the Department of Health, playing help desk for all of these patients that want their cards on day one. But that's great. I mean, you couldn't ask for a better situation where you have people that genuinely are seeking alternative treatment, and you're there to help them. There's no better feeling than that. So, it was wild, and it continues to be wild. But it's amazing.

Chris Holifield: And then COVID happened on top of it, so I'm sure that didn't really help.

Katie Barber: Right. That's been challenging for everybody, especially the Department of Health. And it is strange, I get the most ... Interaction I get now is with patients, and then also happening to talk to people like Tim, or one of the pharmacists at the pharmacies and they tell me these situations where patients are benefiting from it. After you're doing so much every single day to just see people's name on paper, or help write rule, or whatever you're doing for the day, and you don't really get to see that connection then where somebody got help. But those are the moments where you really do remember oh, this has an impact. They're not just numbers, they are patients and they're being benefited by this.

Tim Pickett: So Katie, talk to us about some of the changes that are occurring in the program starting January 1st, 2021. Because I think our listeners are really interested in that. Not everybody knows. I mean, there's a lot of patients on my list that were seen a long time ago who never got their card at all, and still they have this letter. What's-

Katie Barber: Right. So ...

Tim Pickett: What are the changes?

Katie Barber: Yeah. It's that letter. So, previously patients were able to purchase at the pharmacies using a letter. Part of the intent of the legislature, I think, was to allow people who had been possessing product out of state, and might not have been able to get it in-state, due to lack of availability, they wrote into the law that these people could purchase with a letter at these pharmacies. That would be their proof of being able to possess in Utah. So, that went away on December 31st. So, if you had a letter you need a card now. If you had product from somewhere not in Utah, you're illegally possessing. So, that's the major change there.

Chris Holifield: Why couldn't you just keep the letter program going if it was working? Why not just let people keep using letters?

Katie Barber: One big reason I would imagine is that this helps us track better. So, whenever you have a system that's not ... Is manual, it's just going to have more flaws. And that's actually part of the Controlled Substances Act, that it's up until January 1st of 2021 that somebody can possess something with just a letter, or proof of their provider being able to prescribe it. They would be able to possess a letter ... I need to actually think of what the law says. They would be able to possess Medical Cannabis as long as their provider could attest that the provider wanted them to be using it. So, that took the form of a letter, that got turned into letters, and then people were able to purchase. And it just becomes a lot easier to track, to manage, to ... In my opinion, it's better for care over time if you got a system where the provider can see what the patient is getting. That's not something that happens now with the letter process.

Katie Barber: So, I think it's a combination of the legislature wants this to be regulated, we want to be able to track it, we still want people to have access to it. That was the way of making people have access to it, letting people have access to it for as long as possible. And giving them time to convert to a card.

Chris Holifield: When this first launched, I think it was going to be cards from the very beginning. Letters weren't going to work the entire year, but then there were problems with the EVS if I'm not mistaken? Is that kind of why that changed? Or what was the reason for that change?

Katie Barber: It's possible that patient advocacy groups really pushed for an easier way for patients to access Medical Cannabis.

Tim Pickett: Plus… I love talking to you because you're like, "We have no position. We have no-

Chris Holifield: Okay, okay. I get it, I get it.

Tim Pickett: ... position."

Chris Holifield: Yeah, I gotcha.

Katie Barber: We didn't write the law. I know a lot of people think we do, but we didn't. So, obviously we want patients to be able to access cards as easily as possible. When you have a new program, it had a way higher ...

Chris Holifield: Interest.

Katie Barber: Yeah. There was way more interest at the very beginning, and I think a lot of patients reported back to these advocacy groups, or maybe it was to their senators and legislative representatives, that they weren't able to access. We have never been able to confirm that there was some sort of delay on our end, but then you also had issues at the very outset, which is general product availability. So, that could've been another reason that the second bill was passed, to allow patients to purchase with a letter. But it didn't have anything to do with a ... It wasn't a software related issue.

Chris Holifield: I got you.

Katie Barber: The software that we use now is the software that we used then.

Tim Pickett: And it's pretty close to the same process to register, but there ... I remember in the beginning, I mean, we were able to access the EVS system all the way through ... I'll be honest, I was kind of one of the people that was not very pro-expanding this letter program. I thought the EVS system seems to work. It was only taking about a day, or in some cases less than that to get somebody through. But there was certainly was a lot of ... No, there was a lot of talk around the EVS system is totally broken, and bogus, and that sort of thing. Do you feel like now that you have no letters, are you seeing this week, I guess would be your only ... The only timeframe. Are you getting a lot more calls from people and providers, having to now learn this new system?

Katie Barber: Well, one of the great things is that part of the law that was passed required that certain people that had a role in patients accessing Medical Cannabis educated the patients about getting a card. So, personally I think we saw more interest before the end of the year, because more patients actually knew that they did need ... That there was an expiration date to their letters. So, I think we're kind of over that hump, actually, for ... Just personally. That's what I think for how many people are kind of mass emailing, calling, because we did have ... We were backlogged. And we kind of still continue to be backlogged with requests of people just wanting to know how to get a card. We'll often get language to our email, or over the phone about I need to convert to a card from my letter. And it's just kind of interesting, because the letter process, again, was born out of just something that turned into it's standard. That was never the law.

Katie Barber: And it became law. So, I hope that answers your question.

Tim Pickett: Yeah, totally. So, how long right now are you out? Because the law says that we can wait up to 15 days, but I've never seen anybody wait 15 days. How long does it take once the approval ... Once the QMP approves that in the system, how long is the state usually out?

Katie Barber: It'll be less than 15 days. That's the law, that's going to be the max amount of time somebody has to wait. And our turnaround time is usually much faster. I would say within three days people have their cards. That's a long time compared to our typical turnaround.

Tim Pickett: How many cards are you issuing ... Are you approving about a week now?

Katie Barber: Let's see, I'd say an average, a good average for the month is 2,000. So, that would help break it down by week there. It varies.

Tim Pickett: How does it vary? It's always fascinating to me that it varies so much.

Chris Holifield: That what varies?

Tim Pickett: Does it vary with COVID? The appointments.

Chris Holifield: Oh, I gotcha.

Tim Pickett: For cards. That it varies. Healthcare doesn't really vary. Chronic pain doesn't really vary. But for some reason there's 600 this week, and only 200 next week.

Katie Barber: Right, yeah.

Tim Pickett: Does COVID affect the ... Your workload?

Katie Barber: I think when the lockdown first started, it especially did. We had people that were kind of in limbo with treatment just in general for their conditions. And we had a lot of interest, and we still continue to get interest from providers especially, who would like the opportunity to consult patients, either at home or ... Not at home. They want to consult patients with telehealth, or telemedicine, and they're not able to because the law just says they have to meet in person. So, I do think that that did have an impact, because that meant the offices, like yours Tim, they were just reorganizing to accommodate these people. And we have to factor in social distancing, and knowing who's in and out of your door it becomes a lot harder to treat people, whether it's any appointment, any regular appointment for your treatment. It just turns into something different.

Tim Pickett: Do you know the percentage, or the numbers of people who get denied?

Katie Barber: So, really the only population of patients that would get denied are those that are in the Compassionate Use Board group. If we don't have enough information about a patient's certification for Medical Cannabis use in the EVS, they will be marked incomplete. If we don't get that information, it simply expires after 30 days with no change. And most people get something changed within 30 days. So, we don't have a lot of actual denials at all. Even in the Compassionate Use Board, we don't.

Tim Pickett: How many people have gone through the Compassionate Use Board?

Katie Barber: So, we've had 118 approved through the Compassionate Use Board. And I would say only a few more would have been denied. So, that gives you an idea of how many people have actually come through the queue.

Chris Holifield: And aren't you a part of the Compassionate Use Board?

Katie Barber: Yes, yeah. I do everything with the Compassionate Use Board. So, I organize the meetings, I take the minutes, I do the audio, I help providers navigating-

Chris Holifield: I was wondering-

Katie Barber: ... medical records.

Chris Holifield: For our listeners, let's say they're interested in approaching the Compassionate Use Board, do you have any suggestions, or tips? Or words of advice that might help their situation?

Katie Barber: Absolutely. So, our most successful petitioners will have submitted as much information as they can about their diagnosis from their provider. You could write letters too, about why you believe that you should be using Medical Cannabis, you can include research about your diagnosis that we can refer to. But the strongest petitions have the most information about the patient, and what their diagnosis is. So, whether that's x-rays, or consults over time, documentation from multiple providers might be needed. That's one thing that really does help patients. If we know, for example, that your primary care physician is endorsing your Medical Cannabis treatment, or at least has been consulted about your Medical Cannabis treatment, that helps. If the specialist that you go to knows that you want to seek Medical Cannabis treatment, and you make that known to the board through your petition, that will help.

Tim Pickett: Interesting. Okay, so I have a little bit more specific question, and I'll be careful here. If a patient is denied on the Compassionate Use Board, is it typically ... There's only been a few denials. A couple of them have come from our group. And I think that it's because for some reason people refer patients that are underage to me, specifically. If you listen to Representative Ward's so-called pot clinics, will refer their Compassionate Use Board cases to me personally because they know that I know about the Compassionate Use Board. And we have helped a few patients navigate that process. In the denial, there's only been a couple of them, but is it usually something like ... That continuity of care between providers seems to have come up more recently, as kind of an issue that the Compassionate Use Board is considering.

Katie Barber: You're dead on. Yeah. So, I have multiple things to say to this. But the first is it's a process that's in its growth phase. I've been with it since the beginning, and we've had actually a nurse transition out, and a nurse transition in that supports the board. We are still in the process of developing the policies for this board, even what are our bylaws? What are we going to look for? Are we going to have some sort of expedited way for getting these done if we've seen this type of case before? But you bring up a really good point about continuity of care. So, like I mentioned, I probably should've mentioned more in-depth, I say primary care physician, or somebody like a specialist that's treating you, what you'll have, yes, are these patients that haven't had the conversation with their primary care physician yet about Medical Cannabis, or with their specialist. Somebody who's treating them for their condition about for Medical Cannabis, because they assume that they're not going to endorse treatment with Medical Cannabis, so they do seek a different provider that has more experience with the Compassionate Use Board petition process.

Katie Barber: So, if communication happens between everybody, whether that's with a clinic like yours, or it's a different situation with a different clinic, that's going to help. We do like to see, on the board, continuity of care. That will help your petition, just because communication is key in treating you and your health, and maintaining your health. So, that's why it's going to help to communicate between providers. For sure.

Tim Pickett: This is good to know too, that the ... It sounds like the Compassionate Use Board in the beginning kind of had this idea, and that idea is evolving. Because, for example, in Florida if you have a non-approved condition, there is essentially a form that you just fill out and send to the board, and they approve it, just because it's so common. And they have established kind of this workflow. Do you see that ever happening with the Compassionate Use Board? Or do you think that'll take maybe years to develop?

Katie Barber: Oh, I definitely think that could happen. We're setting precedents every time we hold meetings, so I could totally see that happening in the future where it's more of an automatic petition. You barely even have to do anything to petition. And by barely, I mean as long as you have the documentation. If we've seen the same type of case, we are going to be more likely to push that case through, without as much of a ... As much scrutiny, I would say. But the patient does have to do a little bit of work to get to that point. And it will be left up to the board, if that's what they decide. One of the other things is as we grow, we're going to simply have more petitions. Are we going to be able to take more time to review a case? Will time factor into it? What are we going to do to accommodate more cases? Does it mean more meetings? We're still literally answering those questions.

Katie Barber: So, I do see that being a possibility down the line, but also a factor of what if the legislature has question? Then what if they make a law? That means they're going to enforce more time in a process, or require more information in the process. It's just a weird balancing act that, of course the department and the board can inform, but ultimately we don't have final say over. So, I do see that being a possibility, though.

Tim Pickett: Yeah, the Compassionate Use Board is kind of this ... It's this hidden thing, I think, amongst patients and people even in the industry. Even though I think that if we ask somebody like you, there doesn't seem to be a lot of transparency into the Compassionate Use Board yet. So, hopefully that will change as time goes on, and we'll get more transparency into the system. Do you feel like the Compassionate Use Board ... I know we're talking a lot about this, but do you feel like that board is becoming more friendly to cannabis? Or they're pretty set in their opinions?

Katie Barber: So, all of these board members had to have been ... They had to affirm that they would be willing to treat their own patients with Medical Cannabis, or at least they were open to the idea of using Medical Cannabis or else they wouldn't be on this board. That's just a requirement of being on the board. So, over time to see how they work out, sometimes board members want to see that. They want to see progress over time. In an environment where we don't have a double blind study to refer to, this is our closest thing to that, really. These are patients we can even track over time. So, they really do prioritize patient safety, considering what the outcomes will be, and weighting benefit and risk. They're most concerned with that. So, I mean, I don't think it's a question of being friendly to cannabis, it's how can they best be part of a process that has integrity to maintain patient safety, and at the beginning of a process like that we're just going to want to take more time to consider what the effects will be.

Tim Pickett: Speaking of data, you guys did a survey of a bunch of Utah patients, yeah?

Katie Barber: Yeah, we did. We did our first patient survey. Yeah, so that was sent to 4,000 patients in our system. Just randomized patients.

Chris Holifield: What was the survey?

Katie Barber: So, the survey had questions about their treatment. So, some were open-ended questions, like how do you feel this benefited you? Some of them were on a scale of this to this, have you seen a progression in your condition? Will you seek continued care in the Utah market? How do you think the prices are? What do you think about how prices are? What do you think might happen as a result of Medical Cannabis prices in Utah? They had the option to let us know where they thought they would go after being in the program once. Or we were just questioning them on their use before, what they anticipate for the future, questions like that to help us gauge how patients are responding to the program. And then also to the treatment.

Chris Holifield: Do you guys have anything to do with the pricing? You were mentioning the survey asked questions about pricing, and that's kind of a thing people are talking a lot about, the higher prices here in Utah. I was curious now how much you guys control that.

Katie Barber: Zero.

Chris Holifield: Okay.

Katie Barber: There is no control over the prices whatsoever. And that was a decision from the legislature. That could change, too. We don't know.

Chris Holifield: You guys just get that three bucks that they take at the pharmacies, I guess. Right?

Katie Barber: Yeah, there's a $3 transaction fee on top of every purchase.

Chris Holifield: Yeah.

Katie Barber: You could buy $400 worth of product and you'd still only pay $3 to the Department of Health. And then our card prices are pretty low in comparison to other states, too.

Chris Holifield: Oh, absolutely. Yeah, absolutely.

Tim Pickett: Yeah. Just a couple of things that we get questions about all the time. Does the EVS system automatically set my expiration date?

Katie Barber: Yeah. So, the EVS system automatically gives initial patients a 90-day expiration date. Patients who renew after that will get a six-months-out expiration date. I try to tell patients, "That's your default setting." So, a patient that looks closely at the law will notice that the providers actually have the ability to change that date if they want to. The law gives them the ability to limit the participation in the program if they choose, just kind of like writing a prescription for a 90-day supply versus a 30-day supply. Or seeing how the patient reacts to it, and then prescribing more. Kind of like that. Obviously these are not prescriptions, but I think that was kind of the intent. So, those are the default settings for card validity.

Tim Pickett: Are a lot of providers adjusting those dates?

Katie Barber: Not a lot. I think the more providers we have, the more we're going to see that happen, though. Some providers like to have more control over patient treatment, so they want to see their patient in again. Like some other prescriptions, some other very controlled prescriptions, to see how they're reacting to it. So, not a lot of them are doing that, but I just ... Some patients have issues with it, so I'd like to remind them that that's changeable.

Tim Pickett: Right. It is. And I mean, we've used it a couple of times in cases where really I need to see this person back in three months because this is very serious situation, and we want to make sure that we keep up on the patient care. Opioids, for example, that's an every month visit for people. And so, I like to remind people that we're definitely not to that point. But the EVS system, it does the 90-day, and then six months, it does another six months, then it ... Does it default to the annual?

Katie Barber: Yeah. The provider will actually be able to indicate that that person should have a card for a year after they've gone through those two renewal periods. And once they've had their card for a year. So, that's what you're describing Tim, is having your card for a year is a requirement of the law, and then after that time the provider can indicate that they can renew for a full year.

Tim Pickett: But the default is still going to be six months.

Katie Barber: No, it will be a year.

Tim Pickett: Okay.

Katie Barber: After that. They just have to have had their card for a year, and the system is smart enough to know when that happens.

Tim Pickett: Got it. The little technicalities of a program like this are ... They're a burden to the patient in some ways, they're just kind of made up, it feels like, in other ways. Kind of a balancing act, it feels like. Do you feel like the Utah system is a pretty good balance of safety and access?

Katie Barber: I think it is. I personally think it is. I mean, this is not really a situation that has a precedent, where you are taking a law, you're bringing it into a sphere where people can utilize it in a way that is not endorsed by the federal government. You want to also educate the patient as well as you can while enforcing the law. Okay, so a patient acknowledges that they've read the law, they've acknowledged that they've read the law, how do they know what the law says about their renewal? Or whether or not their provider can change the renewal? I think there are ways in which our system could be improved, and I will say our system can be improved, and we are making changes, and that will be just a thing that happens forever and ever. But there are probably ways our system can be improved to kind of better balance that education versus enforcement, or ...

Katie Barber: Yeah. Education versus enforcement for patients so that they know what they're complying with when they submit information, and also why they're complying with it, because I think that tediousness that you feel is a result of just not knowing that these are requirements of the law. Or it could just mean that we need to spend more time educating patients just in the real world, actual communication efforts, and getting out there and getting in front of the public. And of course, for such a small team it's hard to do that at this moment, which is why an opportunity like this talking to you is amazing, because this is one of the few communication channels we have an opportunity to be in front of is people's ears. So, yeah. That tediousness is probably just ... It will be a balance act forever, because it's requirements of the law.

Chris Holifield: You were mentioning you don't have opportunities to get in people's ears. I mean, is there anything that you would like to say, that you want to make sure we talk about?

Katie Barber: Man. There's so many things that we'd like to tell the public about how easy it is to get a card. So, it's a simple process, it really is. I would say one of the biggest hangups that patients have is that they'll go start the process, and go about a third of the way in, and assume they're done. So, one giant thing I would recommend for everybody to do is just to read the instructions about getting your card before you even start the process. Before you even find a provider, just read the instructions, and because a lot of people get that third of the way in, think they're done, when they actually need to talk to their provider, or find a provider. And they could've already done that.

Katie Barber: So, that's one of the things that I think patients can benefit from knowing. The other thing, the other big thing, is that a lot of patients don't have a provider. So, we get questions all the time about what a patient should do if they don't know where to even start to find a provider that can provide care for them, or even approach their current provider about having a conversation about Medical Cannabis, or they don't know whether their current provider will ... Or if they're part of the program, or if they will become a part of the program. So, I always tell patients have that dialog with your provider, see if they're going to be willing to enroll in the program. We always offer the opportunity to speak to your providers if you need that. Our nurse is happy to talk to anybody, anybody on our team is happy to talk to one of your providers and just inform them about the process because it really is an easy process. And that's what we're emphasizing, is it's not that difficult.

Katie Barber: Providers have to go through four hours of CE, so if there's any providers out there listening it's four hours of CE, and then a fee to the Department of Health, and then you're registered. And that means you can care for up to 275 patients, that means you could care for just one patient. But if you're interested in seeking just an alternative way of treating your patients, it's a possibility to consider for you. If any patients reach out asking about assistance finding low-cost healthcare, we have resources for them, too. So, if fees are too high for certain patients, they can come to us and we can give them some resources about applying for a card in a way that's not going to take too much out of their pockets. I also like to remind patients that when they have conversations with their primary care physicians, those primary care physicians have the ability to bill their insurance for treatment.

Katie Barber: So, if your physician, or specialist is open to it, just bill your insurance and then you don't have to pay an out-of-pocket fee to providers if you're not able to pay for that. So, those are a couple things we tell patients where they get stuck, or they don't know what the next step is dialogue, ask us questions, read our instructions, it's an easy process. Communicate with your providers, and if they have any issues they can reach out to our help desk. We're available by email or by phone, and we have also a really quick turnaround time there, too. So, anybody needs help we're happy to do it. And if any of your providers need help, happy to do it. That's what I do most of my time is helping providers through our software, and going to clinics and helping them out with the software. So, yeah. I know it's difficult, and the system is improving, but we're there to help so let us help you.

Tim Pickett: So, you actually will go out? Or somebody will call and say, "Hey, I'm a provider. I need some help with the system," and you'll walk them through the whole process, learning how to certify a patient, learning what that looks like, what renewal statuses are, things like that?

Katie Barber: Yeah. That's what I spend the most of my time doing right now, so even before COVID we were out doing presentations, educating the public and the providers about what the program means, what it's going to mean to be in it, how you become part of the program. And now that we have people that are in it, it's ... Yeah, troubleshooting for providers, teaching providers how to use the system, answering provider questions about the law, what do we require as department of health as part of recommendations, things like that. Yes, we do troubleshooting for the providers and teaching them how to use the system.

Tim Pickett: And there are over 400, or 500 providers in enrolled?

Katie Barber: Yeah. We've got 560 as of last month.

Tim Pickett: And the goal as like 100 in the first year?

Katie Barber: You know what? I'm actually not sure what the goal for providers was. It was low. It was low compared to what it is now, that's for sure.

Tim Pickett: Okay, so I got two things I'm thinking about here. If you spend all of your time right now helping providers navigate the system, what if they allowed everybody to do this just for one or two, or 15 people? That seems like a lot of work.

Katie Barber: Yeah, that could be a lot of work. You might be right about that. It could be a lot of work. So, what might be the alternative, maybe ... I don't know. Who knows what could be the alternative to helping people through it one-by-one. I don't know. If there is any sort of possible legislation in the future that could address that, I would hope that legislation and legislatures listen to how much of an impact that would be if we did have to help every single person through the software. Yeah.

Tim Pickett: That would be a big deal. I know the Department of Health, so I mean, I won't even really ask you the question of where ... What does the Department of Health, or what do you think about this proposed legislation to allow any provider to recommend cannabis for 15 people? Because I don't think you can take a position on that, can you?

Katie Barber: I can not, as an employee of the Department of Health, but personally, just from my own background, my first goal would be obviously to give patients access to the treatment that they need. I would hope, just as a voter myself, as a private citizen, that the legislature would recognize that that's what we're going for here. So, how would they envision that the Department of Health could best enforce a policy that gives a lot of people access while making it easy? I mean, nobody wants something hard, and that's not some sort of opinion from a professional. That's just we don't want things to be hard, they shouldn't have to be this hard.

Chris Holifield: So, what's coming in store for 2021? Anything you want to talk about coming in store for there? Anything that you know or want to share with listeners that way?

Katie Barber: Yeah, absolutely. So, there are exciting things on the horizon for 2021. We've got seven new pharmacies that plan to open by the end of March, and on our website we have an update email list. So, you can sign up for that, you'll be the first to know when those are open. You'll also be the first to know when our home delivery begins. And that is really a big step for our program, because that means that people that are in areas that might not be able to access Medical Cannabis are going to be more likely to be able to access Medical Cannabis. So again, sign up on our website if you want to know about that.

Chris Holifield: Any idea when home delivery might start?

Katie Barber: I know that we are finishing up some of the very last outstanding software bugs that have to take place and get fixed before we launch that. But it will be soon.

Chris Holifield: Very cool.

Tim Pickett: It's going to be pretty cool for home delivery. That's just going to blow the program up.

Katie Barber: Yeah. Well, one of the things that-

Tim Pickett: In rural areas, especially.

Katie Barber: Oh yeah, absolutely. I think one of the things that's most unique about our program is the pharmacy aspect. I am biased, but I love that we have pharmacists, actual pharmacists, involved in this process. And I do think that we stand out among other states because of things like that, and home delivery. And there's actually, in my opinion, there's not a lot of regulation about home delivery. I mean, obviously there is, but it could be so much more tightly controlled than it is. And there's not a ton of hoops to jump through really, for patients to get product. They just use the address on their file, and that's where it gets delivered, and it's really not going to be as kind of crazy as you might think it would be in Utah, to launch something like Medical Cannabis traveling down the road. It's not actually going to be that big of a deal.

Katie Barber: Of course, it's regulated but the access is actually going to be pretty easy, so I'm really thrilled personally, that that access is going to be there, and it's going to come with professionalism. I think that's key. If you want to build a program with integrity, in my opinion that's key.

Chris Holifield: I can't wait.

Tim Pickett: Very cool.

Chris Holifield: It's going to be awesome. A lot of people are eager for that home delivery, but ... Anything else? Anything else coming up? I kind of interrupted you there with the home delivery. Anything else you want to talk about for 2021 that people might need to be aware of?

Katie Barber: Well, those are the two big things-

Chris Holifield: Okay.

Katie Barber: ... that I can think of. I always like to remind patients, and anybody who wants to be involved with this program, whether you're a provider, a neighbor of a patient, a mother of a patient, you have a voice and it can be heard in the legislature. Just this is me saying it personally, but this is how you influence Medical Cannabis law, and if you want to be an active voice in this process you have to at least say something. It's easy to get discouraged when you think your voice might not be being heard. I think a lot of people turn to an entity like the Department of Health to say, "You should change this." But it's actually your senator, and your representative who you'll want to reach out to. And the legislative session begins this month. Really soon. So, get involved, watch the news, see what's going on there, maybe reach out to lobbyist groups, or your senator representative and see how the law's working for you, and what you think might need to be changed to make it better, even.

Katie Barber: So, that's another thing I would say that's on the horizon is the [unintelligible.] And that session starts on the 19th, so it's coming up.

Tim Pickett: Well, this has been great. I am so grateful for you, Katie. You have done more work, frankly, for our patients ... I mean, you're integral in the care of Utah cannabis patients, so thank you very much.

Katie Barber: Happy to do it. And it's providers like you and your clinic that work so hard to keep our program afloat. And you are also an expert in our system, so you have to give yourself more credit too, about how you know how to use our software, because it is hard to use. And we hear all the time about your patients, so we know that a lot of people are getting help through you guys.

Tim Pickett: Thank you. Well, is there anything else Chris, you want to bring up with Katie?

Chris Holifield: I don't think so. I mean, we got a lot of the big things covered. I mean, I think you said the important thing is to go sign up on your email so people can find out when these new pharmacies are opening up? Because that's one of the biggest things I hear too is that people don't know when they're opening up. So, it's like hey, you find out how you can hear right there.

Tim Pickett: Right, where the addresses are, when they're opening up, there's so much talk about St. George, and where is it? And when's it opening? And nobody down there knows. We need to sign up on the Department of Health ... What's the website address?

Katie Barber: The exact website address is medicalcannabis.utah.gov. And the email signup is on every single page on our website, but if you go to the resources page and click on news, you'll get there fastest.

Tim Pickett: Okay, cool.

Chris Holifield: Very cool. And how can listeners reach out to you if they wanted to connect with you? Like an email address? Or anything? Is that something-

Katie Barber: Yep, that'll be email.

Chris Holifield: ... you can give away?

Katie Barber: Well, I'll give you our help desk.

Chris Holifield: Okay, that works, too.

Katie Barber: It's medicalcannabis@utah.gov. If you do want to talk to me, ask for Katie. And I will respond to you. Yeah, and that's goes if you're a provider, if you have any questions about pharmacies, if you're not able to find it just shoot us an email. Any questions about the law, if we're able to answer we will answer.

Chris Holifield: Anything else you want to add? Or how can listeners get ahold of you, Tim, if they're interested to find out more about Medical Cannabis, or what you're up to?

Tim Pickett: Well, utahmarijuana.org is our website, and we have a lot of the same, frankly, information that Katie talks about on the government ... The Department of Health. We want to be a one-stop shop as well, for people and patients to get all of this info about the EVS system, and that sort of thing, too. But if you want to become a patient or you have questions, you can reach out to us, at utahmarijuana.org. And you can find out more about the podcast, all of our podcasts are going to be at utahmarijuana.org/podcast, which is kind of an exciting development for our community here in Utah, the podcast community.

Chris Holifield: Yeah, and we wanted to create more of a little home for you. And speaking of that, call our voicemail line, it would be really cool if you call and left a message. Nobody will ever pick up the voicemail number, but if you have any questions for Tim or myself, or about the podcast, or about cannabis in Utah, or if you're interested in coming on the show, whatever. That number's 385-215-9557, and like I said, nobody will ever pick that up so call that number and leave a voicemail. And we might even play it on the show. You can listen to my other podcast, I am Salt Lake Podcast, iamsaltlake.com. I do that podcast with my wife, Krissie. We have a lot of fun getting to know people in Salt Lake City. We just had a really fun episode with a gentleman who goes by the name of Bad Brad Wheeler. I don't know if either of you guys are familiar with Brad, but he's a great guy. He's got a great story, and he's got a lot of energy to him.

Chris Holifield: So, go listen to-

Tim Pickett: Yeah. And I love that podcast. Check it out.

Chris Holifield: Anything else you want to add, Katie? Any sign-off you want to give for the listeners? Any fancy sign-off?

Katie Barber: A fancy sign-off. Man, just check out our resources. We spent a lot of time on our website, so check out our website. We have the answers there, we have fact sheets, we have facts, we have a locate-your-provider page, and when in doubt send us an email.

Chris Holifield: Awesome. We got to get you back on the podcast, Katie. You are awesome. You are-

Tim Pickett: Yeah. Thanks for coming on.

Chris Holifield: Yeah, thank you so much.

Katie Barber: Thanks for having me.

Tim Pickett: All right, everybody. Stay safe out there.

By UtahMarijuana.org
Published January 26, 2021
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